Health Care Guide

Sore Throat and Strep Throat

Prevention - Home Treatment - When to Call a Health Professional

Most sore throats are caused by viruses and may occur with a cold or may follow a cold. A mild sore throat may be caused by dry air, smoking, air pollution, or yelling. People who have allergies or stuffy noses may breathe through their mouths while sleeping, which can cause a mild sore throat.

Strep throat is a sore throat caused by streptococcal bacteria. It is more common in children from 3 to 15 years of age. A person can get strep throat even if his or her tonsils have been removed.

In general, the more coldlike your symptoms are, the less likely it is that you have strep throat. Strep throat causes some or all of these symptoms:

Severe and sudden sore throat
Fever of 38.3°C (101°F) or higher
Swollen lymph nodes in the neck
White or yellow coating on the tonsils

Strep throat is treated with antibiotics to prevent rheumatic fever. Antibiotics are effective in preventing rheumatic fever if started within 9 days of the onset of the sore throat.

Another cause of persistent sore throat is mononucleosis (mono, or "the kissing disease"), which is caused by the Epstein-Barr virus. Mono is most common in older teens and young adults. In addition to a severe sore throat, fever, and fatigue, mono symptoms often include weakness, body aches, soaking sweats, and swollen lymph nodes in the neck. Another less common symptom is pain in the upper left part of the abdomen caused by enlargement of the spleen. Mono is diagnosed with a blood test called the monospot test.

Most people recover from mono after several weeks. However, for some people it may take several months to get their normal energy level back, and it is normal for the lymph nodes to remain enlarged for up to 1 month (see Swollen Lymph Nodes on See Swollen Lymph Nodes). There is no specific treatment for mono except rest, plenty of fluids, salt water gargles for throat pain, and aspirin or aceta- minophen for body aches. Do not give aspirin to anyone younger than 20.

A less common cause of sore throat is the backflow (reflux) of stomach acid into the throat. Although reflux is often associated with heartburn or an "acid" taste in the mouth, sometimes a sore throat is the only symptom. If you think stomach acid reflux may be causing your throat pain, see Heartburn on See Heartburn.

Prevention

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Drink 8 to 12 glasses of water a day.
Identify and avoid irritants that cause sore throat (such as smoke, fumes, or yelling). For tips on quitting smoking, See Be Tobacco-Free.
Avoid contact with people who have strep throat.
If you have mono, try to keep from spreading the virus: don't share eating or drinking utensils; avoid kissing; and do not donate blood until your symptoms are gone and you are feeling better.

Home Treatment

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Home care is usually all that is needed for viral sore throats. If you are taking antibiotics for strep throat, these tips will also help you feel better.

Gargle with warm salt water ( 5 ml or 1 tsp of salt in 240 ml or 8 oz of water). The salt reduces swelling and discomfort.
If you have postnasal drip, gargle often to prevent more throat irritation.
Drink more fluids to soothe your sore throat. Honey and lemon in hot water or in weak tea may help. Do not give honey to children younger than 1 year of age.
Stop smoking, and avoid other people's smoke.
Acetaminophen, aspirin, or ibuprofen will relieve pain and reduce fever. Do not give aspirin to anyone younger than 20.
Some nonprescription throat lozenges (such as Sucrets Maximum Strength, Cepacol, and Halls Mentho-Lyptus) are safe, effective, and have a local anaesthetic to soothe pain. Regular cough drops or hard candy may also help.

When to Call a Health Professional

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If any one of the following symptoms develops:
Difficulty swallowing
Excessive drooling caused by inability to swallow
Labored or difficult breathing
If you develop a severe sore throat after being exposed to strep throat.
If a sore throat occurs with 2 of these 3 symptoms of strep throat:
Fever of 38.3°C (101°F) or higher
White or yellow coating on the tonsils
Swollen lymph nodes in the neck
If a rash occurs with sore throat. Scarlet fever is a rash that may occur when there is a strep throat infection. Like strep throat, scarlet fever is treated with antibiotics.
If you cannot trace the cause of a sore throat to a cold, allergy, smoking, overuse of your voice, or other irritation.
If a mild sore throat lasts longer than 2 weeks.

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